Representations Regarding Felony Conviction and Tax Delinquent Status for Corporate Applicants & Awardees

OMB 0505-0025

Information collected will be used to evaluate corporate applicants and awardees felony conviction and tax delinquency status prior to entering into new non-procurement contracts, grants, loans, loan guarantees, cooperative agreements and some memoranda of agreement. The information is needed to ensure fiscal year funds are not inappropriately disbursed.

The latest form for Representations Regarding Felony Conviction and Tax Delinquent Status for Corporate Applicants & Awardees expires 2022-06-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Change Justification - OMB Control No. 0505-0025_1.4.23.docx Justification for No Material/Nonsubstantive Change
Change Justification - OMB Control No. 0505-0025_1.4.23.docx Justification for No Material/Nonsubstantive Change
0505-0025 Generic Renewal SuptStmt_v2_Final_OCFO-OCIO.docx Supporting Statement A
0505-0025 Generic Renewal SuptStmt_v2_Final_OCFO-OCIO.docx Supporting Statement A
AD-3030_508-v3.pdf Supplementary Document
AD-3030_508-v3.pdf Supplementary Document

All Historical Document Collections

202301-0505-002 Approved without change	No material or nonsubstantive change to a currently approved collection	2023-01-05
202205-0505-001 Approved with change	Revision of a currently approved collection	2022-06-22
201910-0505-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2019-10-17
201908-0505-001 Approved without change	Generic IC	2019-08-14
201904-0505-002 Approved without change	Revision of a currently approved collection	2019-04-29
201609-0505-001 Approved without change	Generic IC	2016-09-15
201604-0505-001 Approved without change	Revision of a currently approved collection	2016-04-21
201601-0505-001 Withdrawn and continue	Revision of a currently approved collection	2016-02-29
201503-0505-002 Approved without change	No material or nonsubstantive change to a currently approved collection	2015-03-20
201503-0505-001 Withdrawn and continue	No material or nonsubstantive change to a currently approved collection	2015-03-19
201501-0505-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2015-01-20
201304-0505-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2013-04-03
201212-0505-001 Approved without change	Revision of a currently approved collection	2012-12-13
201211-0505-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2012-11-30
201206-0505-005 Approved without change	No material or nonsubstantive change to a currently approved collection	2012-06-29
201206-0505-004 Approved without change	No material or nonsubstantive change to a currently approved collection	2012-06-27
201206-0505-003 Approved without change	New collection (Request for a new OMB Control Number)	2012-06-15